The Covid-19 outbreak has brought about no change at all to our guidance on “do not attempt cardiopulmonary resuscitation” decisions. Those decisions are made by clinicians. However, if a clinician feels that a patient would, as a result of their clinical circumstances, not benefit from CPR, ultimately, like other treatments, it should not be offered. However, other treatments can still be provided and, of course, no doctor would refuse a person’s wish for CPR to be administered if there is a possibility that it would be successful.
On 10 and 17 April last year, letters were issued to general practitioners from the Scottish Government’s chief medical officer, the British Medical Association and the Royal College of General Practitioners providing advice and support on having care planning discussions, within which DNACPR notices may be discussed, if the patient raises the matter.
I thank the cabinet secretary for that answer. However, concerns have been raised by several vulnerable people that they, having been contacted by national health service staff, felt pressured to accept DNACPR orders as part of their anticipatory care plans, due to their vulnerability to Covid-19.
In some cases, such orders seem to have been added to people’s plans without their knowledge or consent, so it appears that there has been a change in use of those orders in the NHS in Scotland. Will the cabinet secretary therefore commit to undertaking a thorough investigation into use of the orders during the pandemic?
I would undertake to commit to an investigation into use of such orders in any circumstances, if there is evidence that they have been used inappropriately by clinicians.
I do not know whether Mr Cameron is referring to historical concerns, which were looked into, or to current concerns, but if he would care to give me detailed information, I will happily take the matter up with our chief medical officer—remembering, of course, that decisions on whether such notices should be applied to particular patients are not Government decisions, but are clinical decisions. Therefore, it is appropriate that, if an investigation were needed, it would be clinically led. I would be happy to look into the issue in any circumstances and will wait to hear from Mr Cameron.